Abstract
AimTo document the prevalence of perturbations of handover meetings and understand how nurses manage temporal, physical and social meeting boundaries in response to perturbations.BackgroundHandovers are joint activities performed collaboratively by participating nurses. Perturbations of handover are frequent and may potentially threaten continuity of care.DesignWe observed and videotaped handovers during five successive days in four nursing care units in two Swiss hospitals in 2009.MethodsVideorecordings were transcribed. All perturbations during the handovers were noted. We performed content analysis of the sources of perturbations from the notes and interactional micro‐analyses of handover interactions based on video and transcripts.ResultsNurses are the most frequent sources of perturbations during handovers. Perturbations are collaboratively managed. A tacit division of labour is enacted via multimodal communication strategies, whereby perturbations are dealt with using both linguistic and bodily signals.
Highlights
Nursing handover meetings ensure transmission of patient information and responsibility between shifts of caregivers
Perturbations are events that impinge on handover meetings
In a field study of handover meetings in nursing units, we examined the frequency of perturbations, their sources and how handover participants maintain the temporal, physical and social boundaries necessary to protect the integrity of handover
Summary
Joint activities are interrelated verbal or bodily actions performed by several people with the shared understanding that they are performing their individual actions as part of a whole (Clark 1996, 2006). They typically involve a joint focus of attention. Joint activities need to be protected by participants This entails managing their temporal, physical and social boundaries. On-going coordination activity remains necessary to orchestrate four aspects of handover boundary management: Beginning the activity, maintaining it in the face of perturbations, suspending and reinstating it to deal with unavoidable perturbations and ending it. We aimed to analyse in detail the collaborative management of perturbations in one selected nursing unit
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